Tess Gerritsen - Harvest

Abby peeled off her gloves and went to pick up the wall phone. "Hello, Dr. Tarasoft? This is Abby DiMatteo, one of the residents. The heart looks great. We should be at your doorstep in an hour and a half."

"That may not be soon enough," answered Tarasoft. Over the line, Abby could hear a lot of background noise: a rapid-fire exchange of voices, the clank of metal instruments. Tarasofthimself sounded tense, distracted. She heard him turn away, talk to someone else. Then he was back on the line. "The boy's coded twice in the last ten minutes. Right now we've got him back in sinus rhythm. But we can't wait any longer. Either we get him on the bypass machine now or we lose him. We may lose him in any event." Again he turned from the receiver, this time to listen to someone. When he came back on line, it was only to say: "We're going to cut. Just get here, OK?"

Abby hung up and said to Vivian: "They're putting Josh on bypass. He's coded twice. They need that heart now."

"It'll take me an hour to free up the kidneys," said Dr. Lim. "Screw the kidneys," snapped Vivian. "We go straight for the heart."

"But-'

"She's right," said Frobisher. He called to the nurse: "Iced saline! Get the Igloo ready. And someone better call an ambulance for transport."

"Shall I scrub in again?" asked Abby.

"No." Vivian reached for the retractor. "We'll be done in a few minutes. We need you for delivery."

"What about my patients?"

"I'll cover for you. Leave your beeper at the OR desk."

One nurse began to pack an Igloo cooler with ice. Another was arranging buckets of cold saline next to the operating table. Frobisher didn't need to issue any more orders; these were cardiac nurses. They knew exactly what to do.

Already, Frobisher's scalpel was moving swiftly, freeing up the heart in preparatory dissection. The organ was still pumping, each beat squeezing oxygen-rich blood into the arteries. Now it was time to stop it, time to shut down the last vestiges of life in Karen Terrio.

Frobisher injected five hundred cc's of a high-potassium solution into the aortic root. The heart beat once. Twice.

And it stopped. It was now flaccid, its muscles paralysed by the sudden infusion of potassium. Abby couldn't help glancing at the monitor. There was no EKG activity. KarenTerrio was finally, and clinically, dead.

A nurse poured a bucket of the iced solution into the chest cavity, quickly chilling the heart. Then Frobisher got to work, ligating, cutting.

Moments later, he lifted the heart out of the chest and slid it gently into a basin. Blood swirled in the cold saline. A nurse stepped forward, holding open a plastic bag. Frobisher gave the heart a few more swishes in the liquid, then eased the rinsed organ into the bag. More iced saline was poured in. The heart was double-bagged and placed in the Igloo.

"It's yours, DiMatteo," said Frobisher. "You ride in the ambulance. I'll follow in my car."

Abby picked up the Igloo. She was already pushing out the OR doors when she heard Vivian's voice calling after her:

"Don't drop it."

I'm holding Josh O" Day's life in my hands, thought Abby as she clutched the Igloo in her lap. Boston traffic, heavy as always at the noon hour, parted like magic before the flashing ambulance lights. Abby had never before ridden in an ambulance. Under other circumstances, she might have enjoyed this ride, the exhilarating experience of watching Boston drivers — the rudest in the world — finally yield the right of way. But at the moment, she was too focused on the cargo she held in her lap, too aware that every second that ticked by was another second drained from the life of Josh O" Day.

"Got yourself a live one in there, huh Doc?" said the ambulance driver. "G. Furillo' according to his nametag. "A heart," said Abby. "A nice one."

"So who's it going to?"

"Seventeen-year-old boy."

Furillo manoeuvred the ambulance around a row of stalled traffic, his loose-jointed arms steering with almost casual grace. "I've done kidney runs, from the airport. But I have to tell you, this is my first heart."

"Mine too," said Abby.

"It stays good — what, five hours?"

"About that."

Furillo glanced at her and grinned. "Relax. I'll get you there with four and a half hours to spare."

"It's not the heart I'm worried about. It's the kid. Last I heard, he wasn't doing so well."

Furillo focused his gaze more intently on the traffic. "We're almost there. Five minutes, tops."

A voice crackled over the radio. "Unit twenty-three, this is Bayside. Unit twenty-three, this is Bayside."

Furillo picked up the microphone. "Twenty-three, Furillo." "Twenty-three, please return to Bayside ER."

"Impossible. I'm transporting live organ to Mass Gen. Do you copy? I'm enroute to Mass Gen."

"Twenty-three, your instructions are to return to Bayside immediately."

"Bayside, try another unit, OK?" We have live organ on board-'

"This order is specific for Unit twenty-three. Return immediately."

"Who' s ordering this?"

"Comes direct from Dr. Aaron Levi. Do not proceed to Mass Gen. Do you copy?"

Furillo glanced at Abby. "What the hell's this all about?"

They found out, thought Abby. Oh God, they found out. And they're trying to stop us…

She looked down at the Igloo containing Karen Terrio's heart. She thought about all the months and years of living that should lie ahead for a boy of seventeen.

She said, "Don't turn around. Keep going."

"What?"

"I said, keep going."

"But they're ordering me-'

"Unit twenty three, this is Bayside," the radio cut in. "Please respond."

"Just get me to Mass Gert!" said Abby. "Do it."

Furillo glanced at the radio. "Jesus H.," he said. "I don't know-'

"OK, then let me off!." ordered Abby. "I'll walk the rest of the way!"

The radio said: "Unit twenty-three, this is Bayside. Please respond immediately."

"Oh, fuck you," Furillo muttered to the radio.

And he stepped on the gas.

A nurse in green scrubs was waiting at the ambulance dock. As Abby stepped out carrying the Igloo, the nurse snapped: "From Bayside?"

"I have the heart."

"Follow me."

Abby had time for only a last wave of thanks to Furillo, then she was following the nurse through the ER. Moving at a near-jog, Abby caught a fast-forward view of corridors and busy hallways. They stepped into an elevator, and the nurse inserted the emergency key.

"How's the boy doing?" asked Abby. "He's on bypass. We couldn't wait." "He coded again?"

"He doesn't stop coding?The nurse glanced at the Igloo. "That's his last chance you've got there."

They stepped off the elevator, made another quick jog through a set of automatic doors, into the surgery wing.

"Here. I'll take the heart," said the nurse.

Through the suite window, Abby saw a dozen masked faces turn to look as the container was passed through the door to a circulating nurse. The Igloo was immediately opened, the heart lifted from its bed of ice.

"If you put on fresh scrubs, you can go in," said a nurse. "Women's locker room's down the hall."

"Thanks. I think I will."

By the time Abby had donned new greens, cap, and shoe covers, the team in the OR had already removed Josh O" Day's diseased heart. Abby slipped in among the throng of personnel, but found she couldn't see a thing over all those shoulders. She could hear the surgeons' conversation, though. It was relaxed, even congenial. All OR's looked alike, the same stainless steel, the same blue-green drapes and bright lights. What varied was the atmosphere for the people working in that room, and the atmosphere was determined by the senior surgeon's personality.

Judging by the easy conversation, evan Tarasoff was a comfortable surgeon to work with.